Transfusion Associated Hyperkalemia and Cardiac Arrest in an Infant after Extracorporeal Membrane Oxygenation
10.4266/kjccm.2015.30.2.132
- Author:
Do Wan KIM
1
;
Kyeong Ryeol CHEON
;
Duck CHO
;
Kyo Seon LEE
;
Hwa Jin CHO
;
In Seok JEONG
Author Information
1. Department of Thoracic and Cardiovascular Surgery, Chonnam National University Hospital, Gwangju, Korea.
- Publication Type:Case Report
- Keywords:
blood transfusion;
extracorporeal membrane oxygenation;
heart arrest;
hyperkalemia
- MeSH:
Blood Transfusion;
Death, Sudden, Cardiac;
Erythrocyte Transfusion;
Erythrocytes;
Extracorporeal Membrane Oxygenation;
Heart Arrest;
Humans;
Hyperkalemia;
Infant;
Infant, Newborn;
Potassium
- From:The Korean Journal of Critical Care Medicine
2015;30(2):132-134
- CountryRepublic of Korea
- Language:English
-
Abstract:
Cardiac arrest associated with hyperkalemia during red blood cell transfusion is a rare but fatal complication. Herein, we report a case of transfusion-associated cardiac arrest following the initiation of extracorporeal membrane oxygenation support in a 9-month old infant. Her serum potassium level was increased to 9.0 mEq/L, soon after the newly primed circuit with pre-stored red blood cell (RBC) was started and followed by sudden cardiac arrest. Eventually, circulation was restored and the potassium level decreased to 5.1 mEq/L after 5 min. Extracorporeal membrane oxygenation (ECMO) priming is a relatively massive transfusion into a pediatric patient. Thus, to prevent cardiac arrest during blood-primed ECMO in neonates and infants, freshly irradiated and washed RBCs should be used when priming the ECMO circuit, to minimize the potassium concentration. Also, physicians should be aware of all possible complications associated with transfusions during ECMO.
